<wicket:extend>

	<div class="col-md-8 col-md-offset-2">
		<div class="panel panel-default">
			<div class="panel-heading">
	    		<h3 class="panel-title">Concepto</h3>
	  		</div>
	  		<div class="panel-body">
            
				<form wicket:id="form" class="form-horizontal">
					<div class="form-group">
			    		<label for="fecha" class="col-sm-3 control-label">Tipo de concepto</label>
			    		<div class="col-sm-3">
			    			<select wicket:id="tipoConcepto" class="form-control"/>
			    		</div>
			  		</div>
					<div class="form-group">
			    		<label for="fecha" class="col-sm-3 control-label">Nombre</label>
			    		<div class="col-sm-5">
			    			<input class="form-control" type="text" onfocus="javascript: this.select();" wicket:id="nombre" maxlength="50"/>
			    		</div>
			  		</div>
					<div class="form-group">
			    		<label for="fecha" class="col-sm-3 control-label">Valor por defecto</label>
			    		<div class="col-sm-2">
			    			<input class="form-control" type="text" onfocus="javascript: this.select();" wicket:id="valorPorDefecto" maxlength="50"/>
			    		</div>
			  		</div>
			  		<div class="form-group">
			    		<div class="col-sm-offset-2 col-sm-10">
							<input type="submit" value="Grabar" id="save" class="btn btn-primary" wicket:id="save"/>
			    		</div>
			  		</div>	                	
				</form>
			
			</div>
		</div>
	</div>
            
</wicket:extend>
